儿童常见疾病的防治常熟教学课件.ppt

* * * * * * Slide 4 Allergic rhinitis and asthma frequently coexist. Most patients with asthma have allergic rhinitis (up to 80%).15-18 Among participants from two French centers in the European Community Respiratory Health Survey (ECRHS), 79% (77/98) of patients with asthma had concurrent rhinitis, and 20% (77/378) with allergic rhinitis had concurrent asthma. Asthma was defined as one or more asthma attacks in the preceding 12 months or positive response to metachloline challenge. Patients were considered to have allergic rhinitis if they responded positively to one or two questions regarding rhinitis symptoms.18 Epidemiologic studies support the suggestion that allergic rhinitis should be suspected as a comorbid condition in most patients with asthma. Ref 15, p 8, L5 Ref 16, pp 897, C2, ?7, L4, 899, Table 4, L19 Ref 17, p 20, C3, ?3 Ref 18, pp 1391, C2, ?3, L1-2, 1393, Table 2 + calc, p 1392, C1, ?1, 3 Calcs: 21+77=9877/98=78.57% 301+77=378 77/378=20% * Slide 8. Can Asthma Be Predicted in Children? Two indices for the prediction of asthma in school-aged children were developed using data from the Tucson Children’s Respiratory Study. A stringent index requires frequent wheezing in the first 3 years of life plus 1 of 2 major criteria (parental diagnosis of asthma, diagnosis of eczema in the child) or 2 of 3 minor criteria (diagnosis of allergic rhinitis in the child, eosinophilia, wheezing apart from colds). A loose index for the prediction of asthma requires any wheezing during the first 3 years of life plus 1 of 2 major criteria or 2 of 3 minor criteria. Children with a positive loose index were up to 5.5 times more likely to have active asthma between 6 and 13 years of age compared with children with a negative loose index. Children with a positive stringent index were up to 9.8 times more likely. More than 95% of children with a negative stringent index never had active asthma between 6 and 13 years of age. Castro-Rodríguez JA, Holberg CJ, Wrigh